This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, January 27, 2014

Weekly Australian Health IT Links – 27th January, 2014.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Well, we are through the silly season and the year actually begins this week after the December / January hiatus.

For those just coming back to work all you really missed was the Government going around floating all sorts of ways of saving money including some ideas around the health sector. There have been no decisions announced on e-Health or the Medicare Locals.

LESS than half of older Australians are willing to share the full contents of their personally controlled electronic health record (PCEHR) with allied health and other non-GP health professionals involved in their care, a survey has revealed.

While 95% of 80 regional Australians over-65 surveyed by researchers from Monash University said they were happy to share their full record with their GP, just 44% said they would allow allied health professionals the same access.

Respondents from Victoria’s Bendigo region were also reluctant to grant full access to others involved in their care. Some 48% said they would share their records with diagnostic laboratories, 46% would allow pathology staff access and 44% were happy for their pharmacist to see their record in full.

The Western NSW Medicare Local (WML) and Blayney Family Medical Practice are encouraging residents and surrounding communities to register for a Personally Controlled Electronic eHealth record (PCEHR) by holding a registration day on Friday, February 7.

WML will be helping and registering community members for a free eHealth record and then doctors will be able to upload a summary of their health information to the system.

Any visitors can attend the registration day and get an eHealth record and have their own GP upload their health summary later.

Health Editor, Sydney Morning Herald

People are being put at risk because there is no way of telling from internet searches if their doctor has broken the rules or is working under sanctions from medical regulators, experts warn.

More than 680,000 health practitioners, including doctors, nurses, and dentists, have their registration status published by the Australian Health Practitioner Regulation Agency (AHPRA), including information about whether special conditions have been placed on their practice because of past bad behaviour.

But lawyers and patient advocates say patients are being left in the dark because the results do not show up in search results. One barrister told Fairfax Media she had clients who had been harmed by a doctor they had researched online, only discovering when they sought legal advice the doctor had conditions placed on them.

Australia privacy rights are regulated by Commonwealth and Australia privacy rights are regulated by Commonwealth and State legislation and the laws protecting confidential information under the common law.

Australian privacy laws govern the collection, use and disclosure of “personal information”. Further, individuals are provided with a right of access and correction of their own personal information. There are also data security, data quality and cross-border transborder data flow requirements.

The Federal Government is considering its response to a review of the controversial Personally Controlled Electronic Health Records system.

The three-member review panel, which was chaired by UnitingCare Health Group Director Richard Royle and included AMA President Dr Steve Hambleton, delivered its report to Health Minister Peter Dutton on 20 December.

Though details of the report and its recommendations have not been disclosed, it is believed to suggest wide-ranging changes to the PCEHR to improve its clinical usefulness and encourage its adoption by patients and doctors.

Mr Dutton said the review looked into significant concerns about the progress and implementation of the PCEHR, and its report “provides a comprehensive plan for the future of electronic health records in Australia”.

Trying to identify just five top priorities in an area as complex and ethically fraught as health care is a tough challenge, but that was the task Australian Medicine set for seven of the nation’s leading health advocates and thinkers, including AMA President Dr Steve Hambleton, the nation’s Chief Medical Officer Professor Chris Baggoley, health policy expert Dr Lesley Russell and World Medical Association Council chair Dr Mukesh Haikerwal. Here they provide their thought-provoking and insightful responses.

AMA President Dr Steve Hambleton

1. Make population health a cross-portfolio priority for all levels of government
Population health is not just about treating illness. It’s also about keeping people well, and all portfolios (Agriculture, Defence, Education, Employment, Environment, Finance, Foreign Affairs and Trade, Health, Immigration and Border Protection, Industry, Infrastructure and Regional Development, Social Services, Treasury etc) need to do their part to fight the threat of non-communicable diseases which stem from tobacco, alcohol, over-nutrition and under- exercise.

2. Continue the investment in closing the life expectancy gap between Aboriginal and Torres Strait Islander peoples and all Australians
All governments need to keep up the investment, but not just in the health portfolio. There is stark evidence that investing in the social determinants of health and a good education, starting at birth, are major predictors of health outcomes.

3. Fix e-health and the PCEHR
We must be able to talk to each other in the same language -general practice, hospitals (public and private), public outpatients, private specialists, aged and community care. Too often the right message just does not get through. Let's get the (e) rail gauge right and use it.

By the end of 2013, over 4,700 General Practices and 600 Community Pharmacies will be using the eHealth record system. There are also around 200 public hospitals across Australia submitting discharge summaries for patients with an eHealth record, and more connecting every month.

Check whether your local hospital is able to submit discharge summaries to the eHealth record system in the table below.

Medical centers pay a high price for the convenience of email--millions of dollars each year as well as a loss in doctor productivity, according to a research letter published in the Journal of the American Medical Association Pediatrics.

Ian Paul, M.D., and Benjamin Levi, M.D., Ph.D., both of the Penn State College of Medicine, examined how long it would take to go through more than 2,000 mass emails Paul received during the 2009-2010 academic year, and what that equated to in dollars.

Queensland Health staff have committed to handing back overpayments worth $3.5 million, the state government announced this morning.

The overpayments are a product of the Queensland Health payroll system debacle. In total 2500 Queensland Health staff members have signed up to repay money, according to Queensland's health minister, Lawrence Springborg.

"I hope to see the number of Queensland Health staff using the new online repayment system continue to rise so we can all put Labor’s payroll debacle behind us," Springborg said.

Drew Turney

There's a crisis looming in scientific data, with a leading scientific journal estimating 80 per cent of current scientific research will be lost in 20 years.

The study, published in Nature, included all data – even paper stored in garages or mouldy basements – but digital-only information may be under even greater threat. Digital conservation and what's called "digital archaeology" (picking up the pieces of data loss) is going to be an increasingly important strategy.

Rackspace chief technology officer Alan Perkins had to restore data from files written by discontinued and unsupported software. "I had to reverse-engineer the encrypted data," he says. "And I noticed several repeating characters every 673 characters, which let me decipher it."

The Victorian government is preparing to move to the next stage of its ICT strategy.

The Victorian government on Monday sought comment on an update to the plan that was launched in February 2013. The government strategy has a rolling two-year plan with an annual update that is designed to keep it up to date.

“The strategy is driving the delivery of better services, reducing duplication, encouraging innovation and improving ICT procurement and project management across government and, as we move towards the second stage, we need to ensure that the Victorian Government takes advantage of the opportunities arising from the ever-evolving ICT industry,” said Victorian technology minister, Gordon Rich-Phillips.

IF Roman armies of ancient times had perpetually used the Latin for "watchword" to verify their identities, friend may have been indistinguishable from foe in battle. Military security would have been breached and Rome's glorious battle history and, ultimately, human civilisation may have panned out differently.

Yet fast forward to 2013 and "password" was the second most commonly used password online, pipped only by "123456". In 2012, "password" was actually No 1.

Splashdata's annual "worst passwords" list illustrates that many take warnings about hacking, identity theft, malware, ransomware and online fraud lightly. Put bluntly, the fastidiousness of the Roman tesserarii, who managed the distribution of watchwords, puts many of us to shame in terms of password security.

NSW Health has begun advertising for its new IT chief, who will take over the soon-to-be-established entity eHealth NSW in an expanded CIO role.

The agency plans to appoint an inaugural chief executive of eHealth NSW by April. The successful candidate will "have a thorough understanding of healthcare delivery within a complex health system, as well as current trends, issues and policy directions in e-health," according to the NSW government's jobs website.

The role encompasses responsibilities once held by departed NSW Health CIO Greg Wells, but will operate at a more senior level, answering directly to director-general Mary Foley.

As part of the 2010/11 Federal budget, the Government announced a $466.7 million investment over two years for a national Personally Controlled Electronic Health Record (PCEHR) system for all Australians who choose to register on-line, from 2012-2013. This initiative has the potential to be a revolutionary step for Australian health care, in terms of both consumer's access to their own health information and improvement in information which will be available to health professionals when they treat a patient.

To date, the uptake has been slow. NeHTA scorecard as at 29 October 2013:

The total number of people who registered for an eHealth record as at 29 October 2013 was 1,042,966.

More than 5,681 healthcare provider organisations have signed onto the eHealth Record system.

8,105 individual doctors, nurses and other healthcare providers throughout Australia has been authorized by their organisations to access the PCEHR system;

More than 15.25 million documents have been uploaded into the PCEHR system.

With respect to the number of providers with HPI-Is that have been linked to access the system, it is NeHTA’s understanding that these numbers are linkages via the provider portal and exclude any linkages through local clinical information systems, so the total number of authorized users can be significantly greater.

Western Australia’s Department of Health has installed another acting executive to head its extensive IT operations.

Bill Leonard has taken over the role of acting CIO at the 40,000-strong organisation.

He replaces Dr Andy Roberson, who had filled in for the past 12 months but has now stepped down to return to his “substantive role” as deputy chief health officer and director of disaster management, regulation and planning.

'I was not gilding the lily'.

Former WA Health director-general Kim Snowball has defended himself against accusations he intentionally downplayed IT problems plaguing the construction of the state’s flagship Fiona Stanley Hospital.

The $2 billion facility will open to patients in October 2014, six months later than originally planned. Delays in the opening of the "paperless" hospital have been attributed to complex and unfinished IT.

Jasper Copping

London: The cold sensation of the doctor's stethoscope has been familiar to patients for decades.

But the device could soon be replaced by new technology, a leading scientific journal has predicted.

It claims that a new generation of hand-held ultrasound devices, modelled on smartphones, are able to diagnose heart, lung and other conditions quicker and with more accuracy than the 200-year-old stethoscope.

The editorial article, in Global Heart, the journal of the World Heart Federation, says: "Many experts have argued that ultrasound has become the stethoscope of the 21st century."

AUSTRALIAN scientists have invented a device that warns people with Parkinson's disease when they are in danger of a bone-breaking fall.

Although backed by serious science, it's a simple headband that gives people time to stabilise themselves before they suffer an unexpected freeze in their walking, which is common in Parkinson's disease.

Most Parkinson's patients are older than 60, and broken bones are one of their biggest dangers.

HE has his own way of seeing my hand, which he shakes, taking "feedback" from its touch. "Michael Curran," he says, folding a collapsible white blind cane in three places. His right hand touches the corner of his kitchen bench upon which he knows, subconsciously, sits a cane fruit bowl with two oranges and two red apples. He knows the colours of orange and red because he saw them long before his vision turned black.

He walks to his lounge room and points to a sofa with a pile of laundry on it, ready to be folded. "Would you like to sit here?" he asks, and then points to a hardwood table to his left. "Or at this stupidly large dining table?"

In this modest lowset brick home in the quiet, suburban Ferny Grove, in Brisbane's west, Michael Curran, a 30-year-old computer software designer, fully blind since he was 15, and his wife, Amy, not fully blind but vision-impaired, raise their two daughters, Gabrielle, five, and Hannah, three. Michael and Amy fell for each other when they were vice-president and treasurer, respectively, of the Young Blind Citizens Victoria advocacy group, where they ran sessions for blind youths about moving out of home as a blind citizen, forming relationships, finding work, becoming a parent. They moved to Queensland in 2010.

MMRGlobal, Inc., also known as MyMedicalRecords, announced this week that it has received a U.S. patent for an app that allows users to store personal health records in the form of voice mail, faxes, email, file upload and other forms of media on their personal devices, according to a statement released by the company. The app will also include an interface that collects and displays prescriptions for submission to pharmacies, allows users to annotate health records and set up appointment rem­­­inders.

"This 10th health IT patent comes at a unique time when awareness of the importance of online access to medical information is at the forefront of everybody's mind,” CEO Robert H. Lorsch said in the statement. “The eHealth market, and specifically the use of Personal Health Records and other products and services including PHRs, EMRs, telemedicine and wireless services that utilize portions of MMR's intellectual property, continues to grow. Additionally, MMR has 18 pending patent applications in the U.S. plus additional applications issued or in various stages of examination globally."

THE AMA has reignited its opposition to Medicare Locals, saying a survey of GPs found almost three quarters believed the organisations were failing to make healthcare delivery easier and should be shut down.

The AMA survey was released as 1700 primary healthcare workers and GPs await the outcome of a review of MLs ordered by Health Minister Peter Dutton. Mr Dutton, who had previously said MLs were an unnecessary bureaucratic layer that should be scrapped, has refused to speculate on how he will respond to the review until it is completed.

By contrast, the AMA, which had initially called for the ML rollout to be frozen on grounds that their corporate structure diluted GP leadership, has more recently softened its stance. In an editorial for MO last year, AMA president Dr Steve Hambleton wrote that it would be too expensive to unwind the organisations and they should instead be “shaped” to improve support for GPs.

·By Clint Boulton - Reporter

CIOs should include detailed project requirement rules in their vendor contracts to indemnify themselves against poor-performing vendors, said Jeff Muscarella, an IT sourcing consultant for NPI Financial LLC. He said adding certain escape clauses will better prepare CIOs when vendor disputes end up in court.

Such vendor management is one of the key problems with health exchanges created under the Affordable Care Act. Despite technical difficulties afflicting state exchanges in Minnesota, Oregon and Massachusetts, contractors responsible for the website-crippling glitches are still on the job. Mr. Muscarella said the complex nature of the health exchanges make it difficult to let contractors go. Difficult, but not impossible, provided CIOs define the rules.

Project Governance. CIOs must include a set of clauses that define how IT problems will be tracked, managed and resolved. This process should cover problem resolution, typically starting with project managers for the customer and the vendor, and then escalating to the vice presidents of IT, if necessary. Failure to resolve these problems usually spurs the CEOs of each party to meet. If the vendor doesn’t observe this clause to the letter, the client can void the contract. “If they don’t manage the project accordingly, that’s grounds for termination,” Mr. Muscarella said.

Iain Gillespie

Recent advances in making computers work like the human brain have pointed the way to a new era in artificial intelligence, and chances are you have already used some of the software improvements involved.

Breakthroughs in deep learning, a process that imitates the brain with digital ''neural networks'' that gather information and react to it independently, have prompted the world's technology giants to invest billions of dollars in a fierce competition to lead the field.

Google co-founder Sergey Brin has been quoted as saying he wants to build the equivalent of the sentient computer HAL from the film 2001: A Space Odyssey, except that it wouldn't kill people. Deep learning might bring that objective a step closer.

SCIENTISTS say they have recorded the first glimpse of the "cosmic web", a colossal network of giant intersecting threads which holds the universe together.

Astronomers have speculated for years that gigantic voids in the universe are crisscrossed by “filaments” of dark matter. These filaments siphon together gases and other material, forming galaxies along their length and tightly packed clusters of galaxies at their junctions.

However, dark matter emits little if any radiation, including light. Consequently, the threads of the cosmic web have only been observed in computer simulations.

After 10 years on Mars, NASA's rover Opportunity has discovered evidence of an ancient wet and mild environment that is much older than previously thought.

The discover is giving scientists further indication that the Red Planet might have been able to sustain life.

"These rocks are older than any we examined earlier in the mission, and they reveal more favorable conditions for microbial life than any evidence previously examined by investigations with Opportunity," said Ray Arvidson, Opportunity's deputy principal investigator and a professor at Washington University in St. Louis.

3 comments:

Anonymous
said...

Thought I might go as well go in and check how my PCEHR is going for 2014, but I can't get in today because the front door system, the mygov.au part where you enter your username and password is down (again), not working with an error message saying they are "working hard to fix the issue." Perhaps I'll try again next year.